Do Economic Evaluations in Primary Care Prevention and the Managementof Hypertension Conform to Good Practice Guidelines? A SystematicReview

摘要

>Background: Results of previous research have identified the need for further investigation into the compliance with good practice guidelines for current decision-analytic modeling (DAM). >Objective: To identify the extent to which recent model-based economic evaluations of interventions focused on lowering the blood pressure (BP) of patients with hypertension conform to published guidelines for DAM in health care using a five-dimension framework developed to assess compliance to DAM guidelines. >Methods: A systematic review of English language articles was undertaken to identify published model-based economic evaluations that examined interventions aimed at lowering BP. The review covered the period January 2000 to March 2015 and included the following electronic bibliographic databases: EMBASE and Medline via Ovid interface and the Centre for Reviews and Dissemination’s (CRD) NHS-EED. Data were extracted based on different components of good practice across five dimensions utilizing a framework to assess compliance to DAM guidelines. >Results: Thirteen articles were included in this review. The review found limited compliance to good practice DAM guidelines, which was most frequently justified by the lack of data.>Conclusions: The assessment of structural uncertainty cannotyet be considered common practice in primary prevention and management ofhypertension, and researchers seem to face difficulties with identifying sourcesof structural uncertainty and then handling them correctly. Additionalguidelines are needed to aid researchers in identifying and managing sources ofpotential structural uncertainty. Adherence to guidelines is not always possibleand it does pose challenges, in particular when there are limitations due todata availability that restrict, for example, a validation process.